Environmentally-mediated health disparities: Selected case studies related to Asian and Pacific Islander Americans

Objective: The paucity of research on environmental health among Asian and Pacific Islander Americans (APIAs) is a well-known gap, despite emerging evidence that suggests disparities in exposure among this population. This presentation reviews the factors (environmental exposures, upstream factors, environmentally mediated health outcomes, community stressors and resources) that may contribute to environmental health disparities among APIAs.

Methods: We searched PubMed and other databases to identify relevant research articles and publications (1989-present) from health advocacy groups, government agencies, and social science/environmental health research to understand the variability of exposure among APIAs.

Results: Segregation of APIAs in U.S. Chinatowns and other ethnic enclaves appear to be correlated with higher exposure to ambient air pollution. The promotion of tobacco internationally, the use of traditional herbal medicine products and dietary practices appear to place APIAs at higher risk of exposure to environmental tobacco smoke and toxic metals such as methyl mercury and Lead compared to non Hispanic whites. APIA subgroups appear to suffer disproportionately from certain Cancers, chronic diseases and occupational health related problems. Asian and Pacific Islander Americans appear to be heterogeneous with regards to environmental exposures.

Conclusions: Our results suggest great heterogeneity in exposures between subgroups in terms of demographics, exposures, and availability of data. Identifying within group variation can be significant in characterizing elevated exposure and risk. This may enable research linkages to upstream factors which may inform better policy and promote culturally appropriate interventions.